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阿立哌唑治疗利培酮所致男性精神分裂症患者泌乳素升高的疗效分析
黄楠苏亮江学锋赵翠陆峥
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摘要:
目的 探讨阿立哌唑治疗利培酮所致男性精神分裂症患者泌乳素升高的疗效及安全性。 方法 60例患者使用利培酮治疗4周末随机分配为研究组(利培酮+阿立哌唑)和对照组(利培酮)各30例, 观察至8 周末。在基线、第4 周末、第8 周末监测两组患者的泌乳素(PRL)水平,并进行阳性与阴性症状 量表(PANSS)和UKU 不良反应量表评估。结果 使用利培酮治疗4 周末,两组患者PRL水平均显著升 高(P< 0.01)。第8 周末研究组PRL水平与自身相比显著降低(P< 0.01),且与对照组比较差异有统计学 意义(P< 0.01);两组患者PANSS 评分均较前显著降低(P< 0.01),但两组间PANSS 评分差异无统计学意 义。两组均多见的不良反应有男性乳房发育、乏力、思睡、静坐不能、肌张力障碍、震颤,但上述不良反 应发生率组间比较差异均无统计学意义(P>0.05)。结论 利培酮可导致男性精神分裂症患者PRL增加, 合并使用阿立哌唑可显著降低利培酮所致的男性精神分裂症患者PRL增高,但未增加不良反应发生率。
关键词:  精神分裂症  阿立哌唑  利培酮  泌乳素
DOI:10.3969/j.issn.1009-6574.2019.03.006
基金项目:国家重点研发计划(2016YFC1306805);国家自然科学基金(81471359);上海市重中之 重临床医学中心和重点学科建设计划(2017ZZ02020);上海申康医院发展中心临床创新三年行动计划 (16CR1032B);上海市精神卫生中心院级课题(2017-YJ-17)
Effect of aripiprazole for risperidone-induced increased prolactin level in male schizophreniapatients
()
Abstract:
Objectives To explore the effect and safety of aripiprazole for risperidone-induced increased prolactin level in male schizophrenia patients. Methods After using risperidone for 4 weeks, a total of 60 patients were randomized to study group( risperidone combined with aripiprazole,n=30) and control group( risperidone,n=30), and then receive treatment until the end of the 8th week. Serum prolactin levels were measured at baseline, the end of the 4th week and the 8thweek. Positive and Negative Syndrome Scale (PANSS) and Udvalg for Kliniske Undersogelser( UKU) side effect rating scale were assessed at baseline, the end of the 4th week and the 8th week. Results After 4 weeks' risperidone treatment, the PRL level of both groups increased significantly( P<0.01). At the end of the 8th week, PRL level of study group was significantly reduced than it at the 4th week( P<0.01), and the difference from control group was statistically significant( P< 0.01). The PANSS score of both groups decreased significantly( P< 0.01), however there was no statistically significance between two groups. The most common adverse reactions in the two groups were breast development in male, fatigue, sleepiness, sedentary dysfunction, dystonia and tremor, but there was no significant difference in the incidence of these adverse reactions between the two groups( P>0.05). Conclusions Risperidone can lead to increasing PRL level of male schizophrenia patients and aripiprazole combined treatment is effective and safe for risperidone-induced hyperprolactinemia, without increase of the incidence of side effects.
Key words:  Schizophrenia  Aripiprazole  Risperidone  Prolactin

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